Posted by BekkaH on July 31, 2002, at 1:10:44
In reply to Zoloft and Pstims - problem together?, posted by rainbowlight on July 28, 2002, at 21:09:35
> I have noticed that I can't drink caffeine while on Zoloft. It makes me jittery and short of breath. Now that I have added Ritalin to my meds I seem to get alot of the physical side effect problems. Do you think it may be the Zoloft causing the problems? Has anyone else been on this combo?
***********************************************Hi Rainbow.
I am unable to take Zoloft and Ritalin together; however, some people do well on that combination. Are you familiar with the cytochrome P450 liver enzymes? Many drugs are metabolized by these enzymes, and some drugs must compete for the same enzymes. Some drugs inhibit enzymes that are required by other drugs in order to be broken down properly. And to make matters worse, some people have what are called "genetic polymorphisms" for the liver enzymes, and they either lack the enzymes or have deficient versions of them. The only way to know whether you fall into that category would be some kind of genetic testing. It's probably easier to discuss your discomfort with your pdoc and try another combination. Zoloft inhibits the cytochrome P450 enzyme known as 2D6. Ritalin is a substrate of 2D6 (i.e., Ritalin needs 2D6 in order to be properly metabolized). Now, let's say that you MIGHT have a deficiency of the 2D6 enzyme (again, we wouldn't know for sure without genetic testing, although adverse reactions to certain drugs might suggest that you would have that deficiency). Add to that the fact that Zoloft is inhibiting the little 2D6 that is available, and the Ritalin will not be broken down. It will build up and cause you to have some unpleasant -- and possibly dangerous -- side effects. I think you should definitely discuss this with your doctor if your discomfort continues.Bekka
poster:BekkaH
thread:114073
URL: http://www.dr-bob.org/babble/20020725/msgs/114550.html